The debate over how children with autism spectrum disorder should be treated in Russia has again turned into a public conflict. The trigger was two new drafts of clinical guidelines: one prepared by the Russian Society of Psychiatrists and the other by the Association of Psychiatrists and Psychologists for Evidence-Based Practice together with the Union of Pediatricians of Russia.
Parents and specialists stress that early and accurate diagnosis is crucial in ASD. In Russia, however, diagnosis is often delayed for years, while the introduction of ICD-11 was suspended in 2024 by a decree signed by Prime Minister Mikhail Mishustin. Critics say this preserves outdated views of autism and hinders timely support for children.
The previous guidelines took effect on January 1, 2025 after a dispute between two professional groups. At that time, the RSP version drew criticism for claiming autism was overdiagnosed, questioning the effectiveness of ABA programs, and allowing haloperidol to be prescribed to children from age two to manage aggression.
In 2026, two versions of the document were again put up for public discussion. St. Petersburg psychiatrist Stepan Krasnoshchekov said he found 69 mistakes in the RSP draft. In his view, the authors rely on an outdated understanding of ASD, propose drugs that should not be used in children, and list inflated dosages.
“The new draft turned out to be lazy, useless, and harmful,” Krasnoshchekov wrote on Telegram.
Critics also note that the RSP draft mentions ABA therapy and the PECS communication system only in passing, even though both are regarded in many countries as evidence-based practices. The State Duma also entered the debate: Ksenia Goryacheva, first deputy chair of the committee on science and higher education, urged Health Minister Mikhail Murashko to revise the draft. The alternative version, published on April 8, received a far warmer response from experts: its authors emphasize behavioral, educational, and psychological interventions and cap the maximum daily dose of risperidone at 3 mg. Public discussion will continue until May 6, after which the Health Ministry is expected to make its decision.